Provider Demographics
NPI:1174687412
Name:SAAVEDRA, WILBERT (DMD,, MS)
Entity Type:Individual
Prefix:DR
First Name:WILBERT
Middle Name:
Last Name:SAAVEDRA
Suffix:
Gender:M
Credentials:DMD,, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8272 W LAKE PLEASANT PKWY
Mailing Address - Street 2:STE. 209
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-7431
Mailing Address - Country:US
Mailing Address - Phone:623-376-6464
Mailing Address - Fax:
Practice Address - Street 1:8272 W LAKE PLEASANT PKWY
Practice Address - Street 2:STE. 209
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-7431
Practice Address - Country:US
Practice Address - Phone:623-376-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD62541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics